Analysis Of The Clinical Characteristics Of Preeclampsia And Pregnancy Complicated With Systemic Lupus Erythematosus And The Study Of Preeclampsia Prediction Based On Urine Proteomics

Preeclampsia(PE)is one of the most significant pregnancy-related hypertensive disorders.In daily practise,we found that PE has some certain similarity with systemic lupus erythematosus(SLE).SLE is a rheumatic illness that often affects pregnancy outcome of young women of reproductive age.Preeclampsia is a common gestational complication.SLE flare and preeclampsia share common clinical features,such as hypertension,proteinuria,and thrombocytopenia,making differentiation between these conditions difficult.The signs and symptoms of new-onset SLE during pregnancy may mimic those of preeclampsia.Arthritis/arthralgia,alopecia,and ulceration were less commonly found in patients with new-onset SLE during pregnancy than in patients who were not pregnant.SLE is a risk factor for preeclampsia.Changes in angiogenic factors precede the onset of preeclampsia in SLE pregnancies.Daily low-dose aspirin may decrease the risk for preeclampsia in pregnant women with lupus.Pregnant women should be treated for SLE flare rather than for preeclampsia when it is difficult to differentiate between these two conditions.To provide further insights into the pathogenesis of PE,we used isobaric tags for relative and absolute quantitation(iTRAQ)proteomics coupled with 2-D LC-MS/MS,to analyze urinary protein profiles from 7 PE patients and 7 normotensive pregnant women.A total of 294 proteins were abnormally expressed in PE patients.Of these,233 were significantly down-regulated and 61 proteins were significantly up-regulated.Bioinformatics analysis using the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)database,found that the most differentially expressed proteins(DEPs)were involved in coagulation and complement pathways,the renin-angiotensin system and cell adhesion molecules(CAMs)pathways.We further validated three of the DEPs by ELISA using 14 pairs of urine samples from PE patients and normal pregnant women.In the subsequent proteomics study of placenta frome PE patients,we found that DEPs of PE placenta are mainly participant in the SLE pathway,which providing us good evidence for the correlation between PE and SLE in both clinical charactor and pathogenesis.